Bill would ban coverage of elective abortions for state workers

March 13--The state couldn't pay for elective abortions for state workers, whether or not the state keeps paying premiums to HMOs or adopts self-insurance, under a bill introduced this month.

But the impact of the bill, if passed, is unclear because such abortions generally are not covered for state workers now, authorities say.

The bill would prevent the Group Insurance Board, which oversees state workers benefits, from contracting with health plans to provide abortions except in cases of rape, incest or to save the life of the woman.

"It would ensure that elective abortions are not funded by taxpayer dollars in the state of Wisconsin," said state Rep. Andre Jacque, R-DePere, one of the bill's sponsors.

The state Department of Employee Trust Funds, which administers state worker benefits, currently requires health plans to cover therapeutic abortions for its members, though the plans can require a prior authorization.

Therapeutic abortions are those considered to be medically necessary, but it's up to the health plans to decide which circumstances meet the definition, ETF spokesman Mark Lamkins said. ETF doesn't know how many abortions are covered each year, Lamkins said.

Al Wearing, chief of sales and insurance operations at Group Health Cooperative of South Central Wisconsin, said Group Health considers therapeutic abortions to be those in cases of rape, incest or to save the life of the woman.

A 2011 bill passed by the state Legislature prohibits coverage of abortions except for the same circumstances for plans in Wisconsin on the Affordable Care Act's exchange. Medicaid coverage for abortions in the state is limited to the same situations.

Wearing said Group Health's plans for groups other than state workers abide by the same rules for coverage of abortions. He said he believes most health plans in Dane County have similar policies.

"I do not believe that (the new bill) would have any impact on (Group Health) since we already exclude elective abortions," Wearing said.

Jacque said some definitions of "therapeutic" abortions are broader, including fetuses that are deformed and the psychological health of the woman.

Spokeswomen for Physicians Plus and Unity Health Insurance said their plans cover therapeutic abortions for ETF members and other groups, but they declined to explain how they define "therapeutic."

A spokesman for Dean Health Plan said only that the company complies with the state's benefit requirements for state workers. A spokesman for WEA Trust didn't respond to requests for comment.

The Group Insurance Board last month approved a plan to self-insure state workers, which is now before the Legislature's budget committee.

Under self-insurance, which Gov. Scott Walker says would save $60 million over two years, the state would pay medical claims directly instead of paying premiums to 17 HMOs, which accept the risk for claims.

Regardless of whatever impact the bill may or may not have on abortion coverage today, it would codify into state law a ban on state funding of elective abortions for state workers, Jacque said.

___

(c)2017 The Wisconsin State Journal (Madison, Wis.)

Visit The Wisconsin State Journal (Madison, Wis.) at www.wisconsinstatejournal.com

Distributed by Tribune Content Agency, LLC.